Esaote Technical Assistance Services

Diagnosis

Esaote aims to deliver precise and reliable diagnosis to meet any clinical need. Integrated solutions for data and image management ensure safe and streamlined workflow.

Application of Ultrasound in Dermatology

 

Clinical Need

To assess correctly benign and malignant skin lesions in the epidermis, dermis, and subcutis, as well blood vessels close to the skin. A precise measurement of skin thickness and evaluation of internal skin structures can provide relevant insights related to the performance of surgical or nonsurgical procedures, therapeutic, cosmetic treatment, and patient follow-up.

 

Clinical applications

I. Benign and malignant skin tumors


Fig. 1 Melanoma stages.

  • In the event of malformations and vascular tumors, ultrasound technology allows the differentiation of lesions with increased blood flow from those with low blood flow, an important fact for the diagnosis.
  • Supports clinical diagnosis and local staging of epithelial tumors, helping to detect tumor borders.
  • A useful tool to monitor cryotherapy or photodynamic therapy treatments.
  • Differentiates melanomas with a Breslow thickness greater than 1 mm and enables early detection of metastases regional sites.


Fig. 2 Lymph node metastasis of a melanoma where the complete rigidity of the lesion and the lack of soft areas are visible.

II. Lymph node enlargement

Lymph nodes have an elastic structure in which the cortex tends to be less rigid than the capsule and the hilum. To assess the stiffness of lymph nodes, elastography technology is used to classify nodes in 4 or 5 categories. Benign enlarged nodes generally tend to be soft, whereas malignant nodes tend to be stiffer.

III. Nail diseases

The evaluation of nail health conditions with ultrasound allows the user to observe pathologies that are located under the nail plate without the need to surgically remove it, leading to a more accurate diagnosis and treatment response.

Fig. 3 Normal nail (crosscut).
P – nail plate
Bd – nail bed
PH – distal phalanx

Fig. 4 Under nail vascular tumour.
P – nail plate
T – vascular tumor
E – erosion in the distal phalanx

Fig. 5 Under nail vascular tumour with colour Doppler.

IV. Inflammatory skin diseases

Detecting the inflammatory stage or the inactive/scar stage of skin inflammations produced by autoimmune diseases is crucial to determine patient treatment.

  • High-frequency ultrasound allows the user to determine to what extent bacterial skin infections have spread to deeper skin layers and guide abscess drainage.
  • The technology allows the detection of hyperkeratosis within the epidermis, inflammation of the underlying tissue, as well increased blood flow in viral warts.
  • Inflammation affects the rigidity of the skin and adnexa structures. Elastography can provide relevant information that is not visible with B-mode ultrasound.
  • Support the user in disease detection and response to treatment, allowing a good differentiation between disease stages.


Fig. 6 Elastography of morphea (M). An increase in rigidity can be observed in the dermal-subdermal interface of the plaque in comparison with the surrounding tissue.

V. Cosmetic Dermatology

Cosmetic fillers display a set of sonographic patterns that allows the user to detect and identify which type of filler was used and support future actions in the event of complications caused by these agents. Ultrasound is also relevant in the assessment of skin response to laser treatment, mesotherapy, and photodynamic therapy.

Clinical Benefits

  • Non-invasive technology in real-time, suitable for a wide range of applications.
  • High-frequency ultrasound allows the user to have an amazing resolution to discriminate echoes.
  • Clear differentiation between structures providing clinical support during diagnosis, follow-up, and treatment.
  • A cost-effective solution, being suitable for different depths, target areas, and patients (from adults to pediatrics).
  • Enhanced power Doppler (up to 16.7 MHz) for extra sensitivity in low flow detection.

 

 

If you liked this white paper, please see the white paper Skin Ultrasound: Where MHz can make a difference available on our website.

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Technology and features are system/configuration dependent. Specifications subject to change without notice. Information might refer to products or modalities not yet approved in all countries. Product images are for illustrative purposes only. For further details, please contact your Esaote sales representative.

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